Chronic kidney disease (CKD) and acute kidney injury (AKI) are public health problems in the US. Reports from the National Institutes of Health, Institute of Medicine and Patient Centered Outcomes Research Institute recommend strengthening training programs for physicians in the methods of clinical research to translate advances in basic science to improvements in health. This application is to renew the training program in Epidemiology, Clinical Trials and Outcomes Research established sixteen years ago within the William B. Schwartz Division of Nephrology at Tufts Medical Center and Tufts University School of Medicine. Andrew S. Levey, MD and Mark J. Sarnak, MD, MS remain the Program Director and Associate Program Director, respectively. The proposed training program is unique in that it combines training by nephrologists with outstanding records in cutting-edge clinical research and by established scientists in epidemiology, biostatistics and health services research. Faculty supervision is complemented by oversight by internal and external advisors, including senior clinical investigators and world leaders in public health related to CKD and AKI. Specific aims 1 and 2 are unchanged but their execution has been substantially strengthened by growth and maturation of research in the Division of Nephrology and integration with the Tufts Clinical and Translational Sciences Institute (CTSI), funded by the NIH: 1) Didactic Training - course work in fulfillment of the MS degree in the Graduate Program in Clinical Research at the Sackler School of Graduate Biomedical Sciences at Tufts University, with 3 areas of concentration. 2) Independent Study - an hypothesis-based research project supervised by a nephrologist mentor and a research team of faculty with expertise in other disciplines. Nephrology faculty and their collaborators have databases and ongoing studies that can serve as the subject of the trainees' research projects. Specific Aim 3 is now more focused on Career Development - to prepare trainees to serve as leaders in academic medicine, government and industry. Integration of all aspects of the curriculum with trainees' research projects is ensured by the nephrologist mentors. Mentor training will be implemented in 2016 in association with the CTSI. All 15 approved trainee positions in the past 5 years have been filled. An additional 13 trainee positions have been supported by other sources during this time. Of the 56 trainees who have completed the program since its inception, 37 took first positions in academic medicine, 5 in industry or government, and 14 in clinical practice. Twenty-three have received grant support. There were 42 applicants for 2014 and 35 for 2015. In view of the declining number of applicants to nephrology programs nationwide, renewal of 2 training positions per year is requested for the next 5 years.